Under Arm Crutches

What Are The Different Type Of Crutches?
Various types of crutches are available: Axillary (also known as underarm crutches), forearm crutches, platform Crutches, strutter and leg support crutches. Crutches are made in all sizes, for adults and children. They are usually tailored to your specific height and needs when at the podiatrist's office.

1. Underarm crutch is the most common type of crutch. Underarm Crutches are usually adjustable and come in wood and Aluminum. When standing normally, the top of the crutch should extend from a point of two to three fingers below the armpit 6 inches to 8 inches outside your foot and should rest at level that allows you to flex your elbow about 30 degree.

Underarm Crutch Measurement & Set-up:

• Place regular walking shoes on the person and assist them in a standing position.
• Place the top underarm pad approximately 5 cm (2–3 finger widths) under the armpit and extend the crutch to a point on the ground about 15 cm from the side of the foot.
• In this position, the handgrip should be adjusted to sit approximately at the height of the wrist crease. This should allow around 15–30 degrees of bend to the elbow.
• Check for the final fit of the crutches. The top of each crutch should be about two finger widths from the underarm, and its wrists should be even with hand grips when the user's arms are on their side.

2. Forearm crutch or elbow crutches gives you increased flexibility that allows you to carry more weight. The cuff on the crutch should be placed 1 inch to 1.5 inches below the back of the elbow. Forearm crutches may not be as stable with full load and are commonly recommended in situations of long-term use for those who may carry weight on both legs but who require additional support. Forearm (or elbow) crutches may not be as stable with full load and are commonly recommended in situations of long-term use for those who may carry weight on both legs but who require additional support. Incorrectly fitted crutches or poor posture may cause a disorder called a crutch palsy in which the nerves under the arm are temporarily or permanently damaged, causing a weakened hand.
  
Forearm Crutch Measurement & Set-up:

• For forearm crutches, measure the height of the handle as with the underarm crutches. Measure from the clenched fist to 2.5 cm below the elbow crease to set the height of the forearm cuff. The forearm cuff should not hinder the movement of the elbow, but should stop the crutch from slipping out of the arm.
• Place regular walking shoes on the person and assist them in a standing position.
• Instruct them to flex their elbows so that the crease of their wrist is level with their hip joints.
• Measure the forearm from 3 inches below the elbow, then add the distance between the wrist and the floor.
• Measure the size of the cuff around the largest part of the forearm.
• Choose a pair of crutches based on the person's measurements. Adjust the length of the crutches up or down to fit the measurements.

3. Platform crutch: Also commonly known as a triceps crutch. The lower cuff should lie 0.5 inches to 1.5 inches below the back of the elbow to avoid bony contact on the arm, yet provide stability.

Platform Crutch Measurement & Set-up:

• Loosen the two knobs on the platform and set the hand grip to its  approximate position. Tighten the knobs. Put the platform crutch bracket on the crutch.
• Remove the two knobs, washers and carriage bolts from the platform arm bracket.
• Put the two carriage bolts into the platform crutch bracket as shown.
• Slide the two carriage bolts through the platform bracket as shown.
• Put one washer on one of the bolts.
• Attach one knob to the carriage bolt with the washer, do not tighten.     Repeat steps 6 and 7 for the other carriage bolt.
• Slide the platform up or down on the crutch to the height that is desired. Adjust the handgrip as described in step 1. Tighten all knobs.
• Make sure that the carriage bolts are seated correctly in the crutch adapter bracket.

4.Strutter crutch: this crutch is a type of underarm crutch with larger crutch tips that remain flat on the floor. This allows for better weight distribution and even more walking.

5. Leg support crutches: They're like a knee scooter. They are common in knee injuries and injuries below, where the entire leg has to be immobilized.
 

Weight should be taken through the hands through the hand pads when using crutches. For Underarm crutches, the top of the crutches should be pressed against the side of the chest wall (approximately 5 cm under the armpit). It is important that the crutches are not positioned high against the armpit, as this may cause damage to the nerves and blood vessels located close to the skin and may also affect posture, balance and stability. The crutches should be positioned slightly to the side and to the front of the body for a stable base of support.

1. Some weight bearings: There are many ways to use crutches depending on the balance and the ability to place weight on one or both legs. If the affected leg is able to hold somebody weight, it is recommended that the crutches and the affected leg be placed forward together for approximately one step (sharing the load between them) followed by the unaffected leg.

2. One-point walking pattern: the crutch and broken leg is one point and the leg that wasn't injured is the other point. The crutches and fractured limbs are advanced as one unit, and the uninvolved weight-bearing limb is brought forward to the crutches as the second unit. This gait pattern is less stable as only two points are in contact with the floor and a good balance is needed to walk with a 2-point crutch gait.

3. Three-point walking pattern: this gait pattern is used when one side of the lower extremity (LE) cannot bear weight (due to fracture, amputation, joint replacement etc). It involves three points of contact with the floor, the crutches serve as a single point, the involved leg as a second point, and the uninvolved leg as a third point. Each crutch and the weight-bearing limb are advanced separately, with two of the three points.

4. Four-point walking pattern: another option is to use a four-point walking pattern, which is slower but may help with safety due to general weakness. This involves putting one crutch forward, then the opposite leg, and then the next crutch forward, followed by the final leg, and continuing with this pattern.

•  No weight-bearing: if the balance is poor and no weight can be taken on the affected leg, then it is suggested that both crutches should be put forward first, followed by a hop forward of the unaffected leg, stopping just behind the crutches and keeping the affected leg clear of the ground. If the balance is good, the hop can swing past the crutches, which will increase speed and fluency.
• Step climbing: To climb upstairs and steps, first lift the unaffected leg up to the step while taking weight on the crutches, and then take the crutches and the affected leg to the second step. To go down, lower the affected leg and lower the crutches first, followed by the unaffected leg second.